National Healthcare Quality and Disparities Report
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Topics
- (-) Access to Care (12)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedSteenland MW, Wilson IB, Matteson KA
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
This study’s objective was to measure the association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities. A total of 60,990 childbirths were reviewed from January 1, 2014 on with a total of 72.3% paid for by Medicaid and 27.7% paid for by a commercial payer. The mean age of the birthing person was 27; with 67% White, 22% Black, and 7% Hispanic. Medicaid expansion in Arkansas was associated with a 27.8 percentage point increase in continuous insurance coverage and an increase in outpatient visits of 0.9 during the first 6 months postpartum, representing relative increases of 54.9% and 75.0%, respectively. Racial disparities in postpartum coverage decreased from 6.3 percentage points before expansion to -2.0 after. However, disparities in outpatient care after expansion persisted between Black and White individuals.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wilson IB, Matteson KA .
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
JAMA Health Forum 2021 Dec;2(12):e214167. doi: 10.1001/jamahealthforum.2021.4167..
Keywords: Medicaid, Maternal Care, Pregnancy, Racial and Ethnic Minorities, Disparities, Policy, Women, Access to Care
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Smith JM, Jarrín OF, Lin H
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The investigators found that among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days.
AHRQ-funded; HS022406.
Citation: Smith JM, Jarrín OF, Lin H .
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
Int J Environ Res Public Health 2021 Mar 19;18(6):3196. doi: 10.3390/ijerph18063196..
Keywords: Elderly, Home Healthcare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Sanchez JI, Shankaran V, Unger JM
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
After colorectal cancer (CRC) surgery, surveillance with colonoscopy is an important step for the early detection of local recurrence. Unfortunately, surveillance colonoscopy is underused, especially among racial/ethnic minorities. This study assessed the association between patient and neighborhood factors and receipt of surveillance colonoscopy. The investigators concluded that receipt of initial surveillance colonoscopy remained low, and that there were acute disparities between Black and NHW patients.
AHRQ-funded; HS013853.
Citation: Sanchez JI, Shankaran V, Unger JM .
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
Cancer 2021 Feb;127(3):412-21. doi: 10.1002/cncr.33262..
Keywords: Colonoscopy, Cancer: Colorectal Cancer, Cancer, Access to Care, Screening, Prevention, Disparities, Medicare
Hammad Mrig E
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
This paper proposes that Pierre Bourdieu's theories of capital and symbolic power can be integrated with fundamental cause theory to address limitations in the latter theory, making it more useful in health disparities research. This work deepens appreciation for the durable relationship between socioeconomic status and health. Study results reveal the multiple and complex mechanisms that play a role in access to healthcare services, which has significant implications for how we think about the role of health policy in addressing health disparities.
AHRQ-funded; HS017589.
Citation: Hammad Mrig E .
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
Sociol Health Illn 2021 Jan;43(1):133-48. doi: 10.1111/1467-9566.13195..
Keywords: Social Determinants of Health, Disparities, Health Insurance, Access to Care, Genetics, Policy
Mallick R, Xie R, Kirklin JK
Race and gender disparities in access to parathyroidectomy: a need to change processes for diagnosis and referral to surgeons.
This study examined whether race and gender disparities impact treatment for hyperparathyroidism with a parathyroidectomy. Data was reviewed on 2289 patients with hypercalcemia and abnormal parathyroid hormone levels who were seen at a tertiary referral center from 2011 to 2016. Cohort median age was 63, and 74% were women. Only 21% patients underwent a parathyroidectomy. Of the patients undergoing surgery, time from initial diagnosis to surgical treatment was longest for African-American men, who waited a median of 13.6 months compared to 2.9 months for Caucasian males. African-American women waited a median of 6.7 months versus 3.5 months for Caucasian women. Surgery rates after 1 year of index abnormal calcium was only 6% for black men versus 20% for white men, and 13% for black women versus 20% for white woman. Substantial delays were found for minorities, particularly for African-American men.
AHRQ-funded; HS023009.
Citation: Mallick R, Xie R, Kirklin JK .
Race and gender disparities in access to parathyroidectomy: a need to change processes for diagnosis and referral to surgeons.
Ann Surg Oncol 2021 Jan;28(1):476-83. doi: 10.1245/s10434-020-08707-z..
Keywords: Racial and Ethnic Minorities, Disparities, Access to Care
Mullen MT, Wiebe DJ, Bowman A
Disparities in accessibility of certified primary stroke centers.
These authors examined the proportion of the U.S. population with less than 60-minute access to Primary Stroke Centers (PSCs). They found significant geographic disparities in access to the PSCs. Stroke belt States have a higher burden of stroke and more limited access to PSCs.
AHRQ-funded; HS013852; HS017960; HS010914
Citation: Mullen MT, Wiebe DJ, Bowman A .
Disparities in accessibility of certified primary stroke centers.
Stroke. 2014 Nov;45(11):3381-8. doi: 10.1161/strokeaha.114.006021..
Keywords: Stroke, Access to Care, Disparities
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Kenik J, Jean-Jacques M, Feinglass J
Explaining racial and ethnic disparities in cholesterol screening.
This study examining the impact of low socioeconomic status, access to care, and language on racial and ethnic disparities in cholesterol screening found that these factors explained most of those disparities. After adjusting for these factors, disparities between whites and Blacks and Hispanics but not Asians and Pacific Islanders were eliminated.
AHRQ-funded; HS021141
Citation: Kenik J, Jean-Jacques M, Feinglass J .
Explaining racial and ethnic disparities in cholesterol screening.
Prev Med. 2014 Aug;65:65-9. doi: 10.1016/j.ypmed.2014.04.026..
Keywords: Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Screening, Access to Care
Moy E, Freeman W
AHRQ Author: Moy E, Freeman W
Federal investments to eliminate racial/ethnic health-care disparities.
The authors presented a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. They proposed that increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication.
AHRQ-authored.
Citation: Moy E, Freeman W .
Federal investments to eliminate racial/ethnic health-care disparities.
Public Health Rep 2014 Jan-Feb;129 Suppl 2:62-70. doi: 10.1177/00333549141291s212.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Vulnerable Populations
Lebrun-Harris LA, Baggett TP, Jenkins DM
AHRQ Author: Ngo-Metzger Q
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
This study examined health status and health care experiences of homeless patients in health centers and compared them to nonhomeless counterparts. It found that homeless patients had worse health status (chronic conditions, mental health problems, and substance abuse) compared with housed respondents. They were also twice as likely to have unmet medical needs in the past year.
AHRQ-authored
Citation: Lebrun-Harris LA, Baggett TP, Jenkins DM .
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
Health Serv Res. 2013 Jun;48(3):992-1017. doi: 10.1111/1475-6773.12009..
Keywords: Health Status, Community-Based Practice, Access to Care, Disparities